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Welcome to the VBP4P newsletter!
The goal of the VBP4P monthly newsletter is to keep stakeholders up to date about program changes and deadlines. The newsletter has three main content areas:
- Need to Do, which will alert stakeholders to information and requirements for successful program participation, such as upcoming deadlines.
- In Other News, which will share other program-related news, such as upcoming webinars or conferences.
- In the Pipeline, which will provide a longer term view of upcoming key VBP4P program dates.
All VBP4P newsletters will be archived in the Newsletters section of the IHA website, so you can easily find and share the latest program information.
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TransUnion Accepting Test Quality & e-Measure Data Files March 21 - May 2
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Between March 21 and May 2, 2018, self-reporting physician organizations (POs) and health plans should submit test data files to TransUnion Healthcare. Test data files support clean final file submission to TransUnion for use in IHA performance measurement, including VBP4P. Instructions for submitting test data files are in the first tab of the data file layout.
Note: Two corrections were made to the data file layouts; the measure ID tag for Asthma Medication Ratio has been updated and the edit check for Cervical Cancer Overscreening has been corrected. While we don't expect this change to affect participant programming of results, it is important that self-reporting POs and health plans review the updated
final data file layouts and work with internal staff or vendors to program files to the correct specifications. See updated
FAQs
for more information.
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Final Measurement Year (MY) 2016 Total Cost of Care Results Forthcoming
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Thank you to everyone who participated in the review period for the preliminary MY 2016 Total Cost of Care results. Participant review is an important process that ensures publicly reported TCC data is
validated
and
comprehensive
. IHA staff will notify participants when final MY 2016 TCC results are available. IHA is working through questions received from participants before finalizing the data and will notify participants when final MY 2016 TCC results are available. As a result of this process, the upcoming OPA Report Card release will only include the Medicare Advantage star ratings.
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NCQA Correction to Shared Risk Adjustment Tables
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NCQA has notified IHA of a correction to their Shared Risk Adjustment table used for HEDIS and VBP4P reporting. NCQA mistakenly updated the HCC-Rank and HCC-Comb tabs to include more comorbidities in the risk adjustment models than in previous years, which could lead to an increase in the expected rate of readmission. Measures affected include the Plan All-Cause Readmissions (PCR) measure reported by health plans and self reporting physician organizations in VBP4P.
To resolve the issue, NCQA has reposted the
Shared Risk Adjustment table and notified stakeholders, including certified vendors and auditors. NCQA-certified vendors will retest logic for all measures impacted to ensure that correct tables are used. Vendors should finish testing by Friday, April 6.
All customers that don't use an NCQA-certified vendor should notify their vendor immediately and ask them to replace the current file with the updated file NCQA posted on Wednesday, March 28. IHA has released an
FAQ with more information. Q
uestions about this issue should be directed to the NCQA
Policy Clarification Support System
.
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California Regional Health Care Cost & Quality Atlas 2.0 Launched
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How does where you live affect the cost of your health care? How do different insurance products compare on cost and quality for different clinical conditions? These are just a few of the questions that the 2nd edition of the California Regional Health Care Cost & Quality Atlas can help answer. Across California, health care costs and quality vary widely unwarranted variation that potentially harms patients and wastes scarce resources. Benchmarking and tracking performance on key quality and cost measures is critical to reducing variation and achieving high-quality, affordable, patient-centered care. As the only source of comparable performance information about the care provided to 29 million Californians, the Atlas brings together multi-payer data from 2013 and 2015, including commercial insurance, Medicare, and Medi-Cal, to help purchasers, health plans, providers, and policymakers target performance improvement initiatives. With continued California Health Care Foundation support and health plan participation, IHA will update the Atlas with 2017 data by the end of 2018. For more information, see the Atlas News Release and Fact Sheet.
Don't miss IHA leaders Jeff Rideout, CEO and Dolores Yanagihara, VP, Analytics and Performance Information, presenting updated findings from the California Regional Health Care Cost & Quality Atlas at the America's Physician Groups 2018 Annual Conference, April 19-21 in San Diego. Stop by the IHA booth and take a guided tour of the Atlas (https://atlas.iha.org) during the exhibit fair and strolling dinner on Friday, April 20 from 6-9 p.m. Learn more and register on the APG conference website.
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New IHA Issue Brief Examines Medi-Cal Managed Care P4P Programs
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Medi-Cal now covers more than one in three Californians - about 13.3 million people in 2017. Roughly 11 million Medi-Cal enrollees get care through managed care plans. As managed care enrollment increases, there is a growing need for common performance measurement across Medi-Cal managed care plans. IHA is working with health plans, providers, and other stakeholders across the state to standardize provider performance measurement through participation in comprehensive PO-level performance measurement programs and adoption of a core set of 10 clinical quality measures by health plans' existing P4P programs. A new IHA issue brief funded by the Pacific Business Group on Health details the findings:
Aligning Performance Measures Across Medi-Cal Managed Care Pay-for-Performance Programs
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California Quality Collaborative Release Annual Impact Report
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CQC
has released its annual Impact Report, highlighting program successes and lessons learned within the California healthcare delivery system. In 2017, CQC programs and collaboratives focused on unearthing best practices for managing total cost of care, transforming primary care, expanding medically complex care, and improving small practices. View the full report
here
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2017-2018 Medicare Advantage Medical Group Report Card
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Thank you to those who participated in the California Office of the Patient Advocate's 2017-2018 Medicare Advantage Medical Group Report Card preview period. Participant review and validation help ensure that publicly reported performance information is available to consumers. Based on questions submitted during the preview period, an update was made to align the IHA methodology to the Centers for Medicare & Medicaid Services star rating methodology. This update resulted in higher overall star ratings and individual measure ratings for several POs, which will be reflected in the report card release April 6.
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Preliminary Quality Reports Available May 25
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The Commercial VBP4P and Medicare Advantage (MA) Stars preliminary reports will be available via the VBP4P Reporting Portal on Friday, May 25, 2018. The Commercial VBP4P Quality Reports include results for the Clinical, Patient Experience, and Advancing Care Information (formerly MUHIT) domains; the MA Stars reports include clinical measure results for your PO. These reports are preliminary and require your careful review once released. IHA staff will host a webinar to correspond with the report release; details about the release, the results, and the accompanying webinar will be included in the May VBP4P newsletter.
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Save the Date! Annual IHA Stakeholders Meeting
October 3, 2018 | Hilton LAX, 5711 West Century Blvd., Los Angeles, CA 90045
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Mark your calendars
for the 17th Annual IHA Stakeholders Meeting on Wednesday, Oct. 3, at the Hilton LAX in Los Angeles. The meeting is the annual forum for all California VBP4P participants and other IHA stakeholders to receive key program information, learn about performance measurement initiatives affecting California providers, and share quality improvement best practices. Stay tuned for additional meeting and registration information!
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